PSA stands for prostate-specific antigen. It is a protein produced by prostate cells.
This article discusses the blood test to measure the amount of PSA in a man's blood. The PSA test is done to help diagnose and follow prostate cancer in men.
A blood sample is needed. For information on how this is done, see: Venipuncture
Make sure your doctor knows all the medications you are taking. Some drugs may cause your PSA levels to be falsely low. These include finasteride, dutasteride, saw palmetto use, and antiandrogen drugs, such as flutamide, nilutamide, and bicalutamide.
No other special preparation is usually needed.
When the needle is inserted to draw blood, some people feel moderate pain while others feel only a prick or stinging sensation. Afterward, there may be some throbbing or a bruise.
Reasons for a PSA test:
For information about prostate cancer screening, see the "Considerations" section below.
PSA test results cannot diagnose prostate cancer. Only a prostate biopsy can diagnose this cancer.
Your doctor will look at your PSA results and must consider your age, your race, medicines you are taking, and many other things to decide whether your PSA is normal and whether you need more tests done.
Older men typically have slightly higher PSA levels than younger men. Commonly used ranges are as follows:
The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.
A high PSA level has been linked to an increased chance of having prostate cancer.
In general, the following results need further follow-up and testing:
PSA testing is an important tool for detecting prostate cancer, but it is not foolproof. Other conditions can cause a rise in PSA, including
Your doctor will think about the following things when deciding on the next step:
People at higher risk may need to have more tests. Your doctor may recommend:
For someone who has been treated for prostate cancer, the PSA level can show if a treatment is working or if the cancer has come back. Often, PSA levels will begin to rise before there are any symptoms, sometimes months or years beforehand.
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
Measuring PSA levels can increase the chance of finding prostate cancer when it is very early.
However, the value of PSA screening for prostate cancer is debated. There is not a single answer that fits all men. Before having the test, it is best to discuss both the reasons to have and the reasons not to have a PSA test with your doctor.
Some questions you may ask your doctor when discussing having a PSA test include:
If a man chooses to be tested, the PSA is most often done every year to screen:
PSA testing is not recommended for screening men over age 75.
Prostate-specific antigen; Prostate cancer screening test
Lim LS, Sherin K; ACPM Prevention Practice Committee. Screening for prostate cancer in U.S. men ACPM position statement on preventive practice. Am J Prev Med. 2008;34:164-170.
Basch E, Oliver TK, Vickers A, Thompson I, Kantoff P, ParnesH , et al. Screening for prostate cancer with prostate-specific antigen testing: American Society of Clinical Oncology provisional clinical opinion. J Clin Oncol. 2012 Aug 20;30(24):3020-5. Epub 2012 Jul 16.
Chou R, Croswell JM, Dana T, Bougatsos C, Blazina I, Fu R,et al. Screening for prostate cancer: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2011 Dec 6;155(11):762-71. Epub2011 Oct 7.
Wolf AM, Wender RC, Etzioni RB, Thompson IM, D'Amico AV, Volk RJ, et al. American Cancer Society guideline for the early detection of prostate cancer: update 2010. CA Cancer J Clin. 2010;60:70-98.
Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School.
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